Kevin Johnson, M.D., is Associate Professor and Vice Chair of the Department of Biomedical Informatics, with a joint appointment in the Department of Pediatrics at Vanderbilt University Medical Center in Nashville. He is a practicing, board-certified physician in Pediatrics, and was recently appointed two Institute of Medicine committees focused on medication safety. Johnson has a unique view on how the clinical and informatics worlds overlap — not to mention how animal husbandry fits in. HCI Managing Editor Stacey Kramer had the opportunity to talk with Johnson about informatics, pediatrics and what it’s like to have bred fish.
SK: I did some background research on you, and I’m so curious about so many things. I don’t know if they relate at all to IT, but if they do, I’d like you to tell me how they do.
KJ: Like what?
SK: You had an octopus?
KJ: That’s on my bio?
SK: No, it’s not. It’s from some other research I did. You grew up in suburban Baltimore? You had snakes, gerbils and an octopus?
KJ: That’s all true. I have absolutely no idea where you found that.
SK: An octopus. That’s insane. Are you kidding me? Wow. Is it true you worked at the National Aquarium and wanted to be a vet?
KJ: Yes. I’ve always been very active in animal husbandry; I’ve always thought it was kind of neat to breed and keep animals at home. Even now, I have a bearded dragon, and I’m about to set up another mini reef system at the house. That’s just sort of a hobby. But when I was a little kid, after the last of my animals escaped my parents said, “There will be no more snakes in the house.” I had all these fish tanks and I went through all the usual fresh water fish, and got where I was breeding — and making money breeding — fish. I used to sell them to all the pet stores in town. After I bred the ones I wanted to breed, I bred some little ones that people don’t usually breed in captivity like gouramies. And of course, the more time you spend at a pet store, the more you see other fish, so I saw saltwater fish. I went through most of the saltwater fish, but they’re hard to breed.
SK: Because there’s no saltwater at home?
KJ: Well, it’s not that. It’s that we actually don’t know anything about how they breed. There’s only probably a dozen saltwater fish that have ever been bred in captivity. They’re really hard to breed. Most of the time they harvest new ones; but clownfish will breed. Coral can be bred, but there are a lot of other things that don’t breed. Most of the big fish, emperor angels and all the beautiful fish, they don’t breed in captivity. You have to get new ones — babies — from the wild.
Anyway, to make a long story short, I went through all those things and in my readings, I found that the octopus was one of the coolest, and I still believe, one of the most interesting pets you can ever have.
SK: I didn’t even know you could have one as a pet.
KJ: They’re really hard to keep; you have to have reasonably cold water with no copper; you have to use special filtration to keep the copper level down to a minimum. And the trick with saltwater fish is that when saltwater fish get parasites, the treatment of choice is copper, and so you can’t have any other fish in the tank that would ever need to have copper introduced or you will kill the octopus. Plus they eat everything. They’re really smart, they eat other animals — they’re purely carnivores. They’re fascinating and become really attached to their owner. They know who you are; they see you come home, and they change color. As you may know, octopus and all the big mollusks — squid, nautiluses — have this ability to change color instantaneously. Mine would be grey, and I would come home and he would literally start having these waves of browns and yellows just go zipping down from his head to basically to the end of his tentacles and literally would come to the top of the tank and wave all of his tentacles, waiting for me to drop some food in the tank.
They really are tremendously fun. When I got interviewed when I was applying for school at Princeton, I actually was asked to show him how the octopus ate, so I fed the octopus a frog. At one point, I had an octopus in captivity longer than anybody else had.
SK: Okay, and informatics?
KJ: It’s related in that I’ve always been kind of inquisitive and intrigued by the kinds of challenges that things like trying to keep an octopus in captivity pose. I think it is this love of the challenge that drove me to do a lot of things in life.
SK: How so?
KJ: Being a pediatrician and having to decide whether pediatrics was right for me. All the things that everybody worries about when they go into medicine: “Is this the right field?” That kind of stuff. There are lots of challenges; I was very interested in doing diagnostic referral and diagnosis of patients, which are some of the more challenging patients. So even though I didn’t choose veterinary medicine, I chose the pediatric population that tended to do the least amount of talking. It’s all kind of the same stuff and I can pretty clearly see this. I see a thread in my own way of thinking about how I would spend my life, starting with my early days and playing with all sorts of animals in the house.
SK: That is really cool, it really is.
KJ: Yeah, if you want to do that story, you should interview my parents because they’ll have a lot more to say about that.
SK: I imagine. How do you say, “Mom, Dad, I want to get an octopus?”
KJ: I’ve never really asked them that question. For me, as I basically didn’t do anything wrong, my parents were pretty permissive. My sisters and I were all that way. I think we have a scarily successful family; my older sister is the Assistant Secretary for Education for the Feds and my younger sister is a Masters-prepared teacher in Columbia, Maryland. So whatever they did basically worked.
SK: Now, in terms of informatics, I’m curious about something that I read about you. It was a quote and you said that when you see a patient and you’re using your computer, it takes longer, but it’s more thorough. I never see anybody really owning up to the fact that it really takes longer.
KJ: We have one study that shows that, I can talk about it briefly.
SK: People don’t usually say that it may be more thorough but that it takes longer. As a physician, you’re on both sides, correct?
KJ: Well, that’s a long answer. I guess the key thing is most of my career in informatics has been spent trying to figure out ways to improve what we called applied clinical informatics, specifically the adoption of tools that can help patient care, either being used by clinicians, nurses, physicians, or potentially patients …
Part II Coming Soon